public health advisory

We have three patients right now who weren’t wearing helmets. Two of them are missing large sections of their skulls, and all three have ventriculostomies draining cerebrospinal fluid, trying to decrease the pressure on their brains. Their CT scans look literally like mush. They’re not dead, and they may, two months from now, leave the hospital, but I doubt if any of them will ever talk again. And there was one earlier in the week who died in the ER (at least one of the ones in the unit was completely expected to die at the scene).

We have at least seven patients who were wearing helmets. A few of them have concussions, but they should all be able to recover completely, neurologically. I think one of them lost a leg, three of them lost their spleens, one lost a kidney, they each have at least two broken bones (not counting ribs) – but that’s not much, since they can all talk. Only one of them is in the ICU.

There are some really cool-looking helmets out there. If you get one of the sleek black ones with the shiny visors, they can be much more macho than going bareheaded. And nobody looks macho with a trach.

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4 Responses to “public health advisory”

If we’re really moving toward universal health care in this country, something’s gotta give. Not to be cynical, but we don’t have unlimited resources. I wonder how many primary care pediatrician visits could be paid for with one of those ICU stays. How many HCTZ prescriptions could be filled with one day on the vent and pressors? Tough questions to think about…

Mmm, yes, but I’ve also been seeing lately that patients who look hopeless when they come in could actually turn out quite well, given enough time and patience – and yes, money. How can we, or worse yet, a faceless bureaucracy, judge who can survive and who can’t, or who’s worth it and who’s not?